Nigerians unaware of blood clots, silent killer behind sudden deaths — Dr. Iheagwam

•Dr. Franklyn Iheagwam

… warns Nigerians on Thrombosis risks, misconceptions

Dr. Franklyn Nonso Iheagwam, a leading biochemist in metabolic and phytotherapeutic research, discusses Nigeria’s silent crisis of blood clots. In this interview with, he highlights the urgent need for public awareness, early detection, and improved healthcare strategies to combat thrombosis and its often-overlooked risk factors, reports Daily Independent.

Excerpts:

How well-informed are Nigerians about the risks and symptoms of blood clots and what are the most common misconceptions?

In Nigeria, public awareness of blood clots, especially serious con­ditions like Deep Vein Thrombosis (DVT) and Pulmonary Embolism (PE), remains worryingly low. Many Nigerians still believe that blood clots only occur in elderly or severely ill in­dividuals, or that they are conditions limited to those who are injured, hos­pitalised, or immobile.

In reality, symp­toms such as unexplained swelling in the leg, sudden shortness of breath, or chest pain can affect otherwise healthy individuals and often go un­noticed or misattributed to unrelated issues. Pregnancy, varicose veins, and chronic illnesses like diabetes, cancer, and obesity significantly increase clot­ting risk, yet such knowledge remains absent from public health messaging.

More than ever, Nigerians need target­ed education on the signs of throm­bosis and the importance of seeking timely medical attention.

What are the leading causes of blood clots among Nigerians and how do lifestyle, ge­netics, and healthcare access contribute to these risks?

Blood clots in Nigerians arise from a complex interaction of biological predispositions and environmental exposures. Chronic metabolic condi­tions such as diabetes, hypertension, and obesity are now widespread in Nigeria and contribute heavily to the pathogenesis of thrombotic events.

In my work on diabetic models, I have shown that hyperglycemia induces systemic inflammation and disrupts blood cell integrity, thereby promot­ing a pro-thrombotic state (https://doi. org/10.14202/vetworld.2023.1593-1599). These findings are especially relevant as Nigeria continues to face a rise in non-communicable diseases.

Addi­tionally, lifestyle factors like prolonged physical inactivity, dehydration, poor nutrition, and even long-distance travel play crucial roles in clot forma­tion.

Smoking, though less prevalent than in Western countries, is on the rise among young adults and also contributes to endothelial damage. Genetics is another area of concern, though it remains understudied in the Nigerian population.

Conditions such as inherited thrombophilia or deficiencies in natural anticoagulants may go undetected due to the lack of routine genetic screening.

Healthcare access further complicates the picture. Many Nigerians do not undergo rou­tine screenings for cardiovascular or clotting risk factors, meaning that early warning signs are frequently missed. The failure to incorporate co­agulation risk assessments into rou­tine care, especially in patients with chronic illnesses, continues to delay intervention and worsen outcomes.

Trauma and Emergency Response: How ef­fective is Nigeria’s emergency response sys­tem in managing traumatic injuries that could lead to blood clots or other complications?

Nigeria’s emergency response system is still developing and, in its current state, lacks the capacity to adequately manage trauma-related complications such as blood clots. Am­bulance services are limited to major urban centers and are often poorly equipped.

In rural areas, emergency transportation is mostly informal, with patients frequently relying on motorcycles or private vehicles.

A very troublesome aspect is the populace’s perception to ensuring a free flow of traffic for emergency vehicles, which is very poor and almost non-existent. This delay in transport and absence of early care significantly increases the risk of post-traumatic complica­tions, including clot formation.

Inside hospitals, particularly in underfunded settings, critical diagnostic tools like Doppler ultrasound or CT angiogra­phy — used to detect DVT or PE — are either unavailable or financially in­accessible to most patients.

Clotting disorders, especially when linked to trauma or surgery, are frequently un­derdiagnosed due to a lack of clinical suspicion and poor access to diagnos­tic equipment. Without consistent emergency protocols or specialised personnel trained in managing these complications, Nigeria’s trauma care system remains ill-equipped to pre­vent or treat thromboembolic events effectively.

What role do road traffic accidents and occu­pational hazards play in trauma-related blood clot cases in Nigeria?

Trauma, especially from road traf­fic accidents (RTAs), is one of the most significant contributors to clot-related complications in Nigeria.

The coun­try has one of the highest RTA rates globally, with young adults —particu­larly men — forming the majority of victims. These accidents often result in fractures and prolonged immobil­ity, which are well-known risk fac­tors for venous thromboembolism. Post-trauma surgeries and orthopedic procedures further elevate this risk, particularly when patients do not re­ceive preventive anticoagulation or physiotherapy.

Occupational injuries, especially in industrial, agricultural, and construction settings, also con­tribute to clot risk. Workers in these environments often experience crush injuries, repetitive physical strain, or prolonged immobilization, all of which disrupt blood flow and initiate clotting cascades.

The urgent need for improved workplace safety poli­cies and better enforcement of labor health standards cannot be overem­phasised. Trauma prevention should not only focus on immediate physical injuries but must also account for the long-term risk of complications such as DVT and PE, which often develop silently after the initial trauma is managed.

Treatment and Public Health Strategy: What are the current challenges in diagnosing and treating blood clots in Nigerian hospitals, es­pecially in rural or under-resourced areas?

The diagnosis and treatment of blood clots in Nigeria are hindered by systemic weaknesses in healthcare de­livery, particularly in under-resourced and rural settings.

Many hospitals lack essential laboratory tools need­ed to assess coagulation profiles, such as D-dimer assays, Prothrombin Time (PT), or activated Partial Thrombo­plastin Time (aPTT). This means that even when clinical suspicion arises, confirmatory testing may be impos­sible or delayed. Treatment options are similarly limited; anticoagulants like heparin or warfarin are often un­available or unaffordable. Inequitable distribution of healthcare resources is a major factor driving poor outcomes in clot-related cases.

Patients in rural communities often present late or sometimes develop complications post-trauma, due to distance from care facilities and a lack of transpor­tation options. Furthermore, many healthcare workers are not adequately trained in identifying early signs of thromboembolism, leading to missed or incorrect diagnoses.

Addressing these gaps will require investments in diagnostics, medicine supply chains, and professional training —especially for primary care providers who serve as the first point of contact for most Nigerians.

How can public health campaigns and community outreach help reduce the incidence of trauma and improve early detection of blood clots?

Community education and public health campaigns offer one of the most effective pathways to reduc­ing the burden of trauma and blood clot-related complications in Nigeria.

Health messaging that is both relat­able and culturally contextual, such as campaigns, could explain that long bus rides without movement, leg pain after injury, or swelling follow­ing childbirth are not simply signs of fatigue but could indicate serious vascular issues.

These messages should be delivered through trusted local channels such as religious cen­ters, radio programs, and community health workers who understand the cultural landscape.

Moreover, work­places and schools are ideal venues for preventative messaging about mo­bility, hydration, and early warning signs, creating a culture of vigilance. Grassroots involvement is critical as it involves local leaders and training community health extension work­ers to recognise clot symptoms, early patient referral, and bridge the gap between traditional beliefs and bio­medical care.

Integrating traditional knowledge with evidence-based med­icine while incorporating accessible and respectful education can enhance health literacy, promote preventive behaviors, and ultimately reduce the incidence of life-threatening clotting conditions.

In all, blood clots are silent until they become life-threatening. Build­ing community awareness, expand­ing diagnostic access, and integrating public health with cultural sensitivity can turn the tide in Nigeria.